The Lancet Report vs. Iraq Body Count

A few days
back I made note of the report in The
Lancet on recently-completed research in Iraq of how death rates have
changed in the months since 2002.

The study’s authors estimated that 100,000 more Iraqis had died in
the months after the invasion that started in
March, 2003 than would have died had the death rates in Iraq remained
the same as their pre-war levels. This increased death rate was almost
entirely due to deaths from war violence, and those deaths were overwhelmingly
the result of coalition “aerial weaponry.”

This 100,000 number raised eyebrows, since until now, the closest thing to
rigorous civilian mortality figures had been from sources like
Iraq Body
Count, and the press had gotten used to writing paragraphs
juxtaposing the Iraq Body Count figures (at this
writing: 15,285 ± 1,066) with the boilerplate Pentagon assertion that they do
everything possible to
minimize civilian casualties.
(The Pentagon does not release its own estimates of the civilian casualties
its actions cause, and in fact frequently insists that it
does not even generate such estimates.
The Iraq Health Ministry was doing its own counts for a while, but
was ordered to stop.)

The huge difference between the Iraq Body Count and
Lancet numbers is not surprising. While both counts
are an attempt to get some estimate of the war’s impact, they are actually
counting very different things. In short:

Iraq Body Count counts all civilian deaths in
Iraq since January, 2003 that were
caused by coalition military action and that were mentioned in at least
two independently-generated reports in certain of the major
English-language news media. (See their
Methodology
page for more detail.)

The Lancet report is a statistical extrapolation
from a random sample of households in Iraq, where people in the household
were interviewed to determine deaths in that household from all
causes in months surrounding the
invasion.

Clearly, they’re counting very different things, and you would expect that the
Iraq Body Count figures — which only count a death
if two, independent, major, English-language media sources report on it and
agree that the dead person was a civilian and was killed by coalition action
(or perhaps,
negligent inaction1) — would
be lower by far than the actual fatality figures, and lower than the
Lancet results too, unless you were confident that
the over-all health situation had improved so much in Iraq since the invasion
as to counteract the effects of warfare.

The Lancet’s report
is generous with the details about how the study was conducted and the
difficulties involved with doing such a study in occupied Iraq. For instance,
part of the study involved picking a random starting point with
GPS
coordinates, and then finding the thirty interviewable households closest to
that point. However, in one of those random starting points, this technique
could not be used:

Falluja was the only cluster where
GPS
units could not be used to find the random starting point. These devices have
military uses and their possession resulted in the imprisonment and death of
many Iraqis during the previous regime. Since interviewers were stopped and
searched repeatedly getting into Falluja, the use of a
GPS unit
could have resulted in the killing of interviewers. Stopping a car in Falluja
at a random point at the date of the visit
(Sept 20)
and walking away from it was also likely to result in the killing of
interviewers. For Falluja, the team assumed an approximate size of the town.
They picked a distance down a main road and a number of blocks to the side
based on random number selection. Interviewers walked the final 700
m estimating the distance. This
presents the potential of subconscious or other forces influencing the
selection of the starting point.

The Falluja data sample, as it turned out, was not only difficult to collect
but difficult to analyze: two-thirds of the violent deaths recorded in the
study happened there, making it an “extreme statistical outlier,” and also,
atypically, “23 households of 52 visited (44%) were either temporarily or
permanently abandoned. Neighbours interviewed described widespread death in
most of the abandoned houses but could not give adequate details for inclusion
in the survey.” (This highlights one deficiency of the study’s method — if
everybody in a household is killed, or if enough are that the
household no longer exists as such, this study’s method will not notice them.
You can’t interview a pile of rubble.)

Because of this, for most of the conclusions in the
Lancet study (including the “100,000” estimate), the
data from the Falluja cluster were not included.

People better at statistics than myself have
criticized the
meaningfulness of numbers generated under such difficult conditions, and these
criticisms have
themselves been criticized by folks, who probably, unlike myself, passed
their introductory stats class with a grade that helped their average.

That said, I won’t be entirely shy about drawing some conclusions from this
study. What jumped out at me was that the increase in deaths noticed by the
Lancet researchers was largely the result of violent
deaths (one such before the invasion, seventy-three after, or twenty-one if
you exclude Falluja), and that these violent deaths were overwhelmingly due to
coalition airstrikes: two were attributed to anti-coalition forces, one to the
old regime during the invasion, seven were criminal, two were unknown, the
other 61 were caused by the coalition — three with small-arms
fire2 and the remaining 58
“caused by helicopter gunships, rockets, or other forms of aerial weaponry.”

It bears repeating that the press conference lullaby about the coalition doing
all it can to avoid civilian casualties is as much a lie as any of Stalin-era
Pravda’s grain harvest reports. At least the
editors of Pravda had the excuse that they’d be
taken out and shot if they didn’t print the lies.

The coalition is inflicting effectively indiscriminate destruction on civilian
areas with massive aerial firepower. And a new assault on Falluja is expected
any day now.

In the early days of the invasion attempts to kill the Iraqi leadership
through “precision” bombings, sometimes in civilian neighborhoods,
went 0 for 50,
meanwhile destroying whole blocks of homes and those inside. Did the
coalition, in its eagerness to minimize civilian casualties, give up on this
technique? Hardly. Instead, it seems to have taken
Paul Tibbets’s advice regarding civilian
casualties: “That’s their tough luck for being there.”
Hardly a day goes by when the press doesn’t credulously report that the
coalition has bombed
a Zarqawi “safe house” — using the same sort of intelligence, the same techniques, and ultimately the
same results (al-Zarqawi still seems to be on the loose, but those houses are
dropping like dominoes3).

The coalition has chosen less-risky, more expensive, more cowardly, and more
indiscriminately lethal forms of warfare to meet its
objectives.4 That is what
precision, guided bombs and helicopter gunships are for. If the worst that can
happen if your target doesn’t turn out to be what you hoped it was is that
innocent civilians get killed and maimed, well, what’s holding you back but
decency and respect for humanity (and who’d be in uniform in Iraq if they were
burdened by any of that)?

Iraq Body Count now says
that “In the current occupation phase this database includes all deaths which
the Occupying Authority has a binding responsibility to prevent under the
Geneva Conventions and Hague Regulations. This includes civilian deaths
resulting from the breakdown in law and order, and deaths due to inadequate
health care or sanitation.” But I doubt that many such deaths are considered
newsworthy enough to meet their reporting requirements.

“In one of the three cases, the 56-year-old man killed
might have been a combatant. In a second case, a 72-year-old man was shot at a
checkpoint. In the third, an armed guard was mistaken for a combatant and shot
during a skirmish. In the latter two cases, American soldiers apologised to
the families of the descendants for the killings, indicating a clear
understanding of the adverse consequences of their use of force.” Evidence,
perhaps, both that even in more direct, face-to-face combat, the
U.S. is fairly
careless about whom they’re shooting at; or, more charitably, that when they’re
not bombing the battlefield from afar, virtual-reality style, they’re more
sensitive to the consequences of their mistakes.

Riverbend at
Baghdad Burning makes al-Zarqawi out to be an
Emmanuel Goldstein: “Everyone here knows Abu Mussab Al-Zarqawi isn’t in Falloojeh.
He isn’t anywhere, as far as anyone can tell. He’s like the
WMD:
surrender your weapons or else we’ll attack. Now that the damage is done, it
is discovered that there were no weapons. It will be the same with Zarqawi. We
laugh here when we hear one of our new politicians discuss him. He’s even
better than the
WMD — he has legs. As soon as the debacle in Falloojeh is over, Zarqawi will just
move conveniently to Iran, Syria, or even North Korea. ¶ …They’ve been bombing
Falloojeh for several weeks now. They usually do the bombing during the night,
and no one is there to cover the damage and all the deaths. It’s only later we
hear about complete families being buried alive or shot to death by snipers on
the street.”

And here I find a better-worded echo on
Crooked Timber:
“The use of air strikes in civilian areas foreseeably results in increased
civilian deaths. Going into a built-up area with troops to raid a (possibly
booby-trapped) house used by insurgents exposes soldiers to greatly increased
risk of death or serious injury; calling in an airstrike doesn’t. But we know
from other theatres that such strikes often kill numbers of bystanders. The
risk of the operation is transferred by deliberate and systematic policy from
soldiers to bystanders. Such a policy runs contrary to traditional views about
who should bear the risk of operations: we can’t insulate civilians completely
but where there’s a choice soldiers both in virtue of the role they occupy and
the fact (here) that they are volunteers should take on more exposure in order
to protect civilians. It is hard to escape the thought that were co-nationals
of the people dropping the bombs the ones in the bystander position, different
methods would be used.”*

* (There’s something satisfyingly perverse about
footnoting a footnote, don’t you think?) The folks at
Kuro5hin
have risen to the Crooked Timber challenge by
modestly proposing that the insurgency-fighting techniques that have worked
so well in Falluja be imported back to the United States to combat our own
problems with crime and what-not.

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